Abstract 10947: The External Validity of Prediction Models for Contrast-Induced Nephropathy After TAVI: Insights From the Brazilian TAVI Registry

• Published in: Circulation (New York, N.Y.) Vol. 138; no. Suppl_1 Suppl 1; p. A10947
• Main Authors: Rosa, Vitor E E, Campos, Carlos M, Bacelar, Antonio, Abizaid, Alexandre A C, Mangione, José A, Lemos, Pedro A, Esteves, Vinicius, Caramori, Paulo, Tarasoutchi, Flávio, Brito, Fabio S
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 06.11.2018
• ISSN: 0009-7322; 1524-4539

IntroductionAcute kidney injury (AKI) has shown to adversely affect outcomes in patients undergoing transcatheter aortic valve implantation (TAVI). The aim of the study was to test and compare 6 scores in predicting AKI after TAVI.HypothesisThere are other factors beyond contrast nephrotoxicity that con influence on AKI in patients undergoing TAVI, so current scores could not predict AKI in those patients.MethodsWe tested 6 scores (Contrast material limit score; Volume-to-Creatinine Clearance Ratio; ACEF; CR4EATME3AD3; Mehran Model A and Mehran Model B) in a total of 559 consecutive patients included in the Brazilian TAVI Registry.ResultsAll scores had poor accuracy and calibration to predict the occurrence of any AKI (Figure 1A). There was an improvement in AKI risk prediction when stratified for AKI grades 2/3 and AKI grade 3 for all scores. However, only CR4EATME3AD3 was predictor of AKI stages 2 or 3 (AUC0.62; OR1.12; 95% CI 1.01-1.26; P=0.04) and AKI stage 3 (AUC0.64; OR1.16 95% CI 1.02-1.32) (Figure 1B and C). Mehran models A and B were predictors of AKI stage 3 (AUC0.63; OR1.10; 95% CI 1.01-1.22; P=0.05; and AUC0.62; OR1.10; 95% CI 1.00-1.21; P=0.05, respectively).ConclusionsAll 6 scores had poor accuracy to predict the occurrence of AKI at earlier stages. However, CR4EATME3AD3 had the best accuracy in prediction of AKI grades 2/3 and AKI grade 3.Figure 1. Left panels show the Receiver Operating Characteristic (ROC) curves of the 6 scores for prediction of any AKI (A); AKI stages 2/3 (B) and AKI stage 3. Right panels are calibration plots for % of predicted and observed risk among quintiles for the 6 tested scores.Vol=volume (mL); Cr=creatinine (mg/dl).